Skip to Content
Change lives. Change organizations. Change the world.

Center for
Social Innovation

Center for Social Innovation

Social Entrepreneurship

Embrace: Deciding on a Hybrid Structure

Academic Case Study by:
Stefanos Zenios, Lyn Denend, Amy Lockwood, Stacey McCutcheon
Published: 2012
[photo - Embrace]

While attending Stanford, the Embrace team developed an idea for an innovative infant warmer to help low-birth-weight infants. The early prototype looked much like a sleeping bag for babies. While the form factor was unique, the real breakthrough was a reusable pouch of phase-change material that could be heated to 98-degrees Fahrenheit and maintain that temperature for several hours. When inserted into the sleeping bag, it would safely and reliably keep the baby warm. As designed, the warmer was small and light, transportable, and easy to use. Importantly, it also had the potential to be produced at a fraction of the cost of available incubators, even those already designed for the developing world.

Enthusiastic about the possibility of helping millions of low-birth-weight babies, the team decided to pursue their idea beyond the end of the course, creating a nonprofit called Embrace Global to further develop and commercialize the technology. Over time, however, the team discovered that it had underestimated the amount of time required to raise the needed capital to transition from a prototype to a market-ready product. After consulting with its board of directors, other advisors, and legal experts, the team thought that, at this stage in its development, becoming a for-profit or hybrid organization could position it for faster growth and greater scalability because it would be able to access larger sums of money in the form of equity investments. However, Embrace realized that as a company with private investors, who would be seeking a financial return on their invested capital, it could be more difficult for Embrace to justify targeting markets and customer segments that were considered small or otherwise unattractive by commercial standards. This mini-case study explores how Embrace decided to pursue a hybrid structure and the steps it took to balance these competing priorities in devising the new model.

[Read Case]

This story is part of the Global Health Innovation Insight Series developed at Stanford University to shed light on the challenges that global health innovators face as they seek to develop and implement new products and services that address needs in resource-constrained settings.  

Acknowledgements: We would like to thank Jane Chen of Embrace for her participation. This research was supported by the National Institutes of Health grant 1 RC4 TW008781-01.

Photo credit: Courtesy of Embrace

CycleBeads II: Creating a Dual Market

Academic Case Study by:
Stefanos Zenios, Lyn Denend, Julie Manriquez
Published: 2012
[photo - Cycle Beads]

To help address the issue of unplanned pregnancy and maternal mortality in the developing world, researchers at the University of Georgetown’s Institute for Reproductive Health (IRH) recognized the need for an intuitive, natural contraception method that could meet the needs of families that chose not to use medical or surgical alternatives. IRH developed the Standard Days Method (SDM), a simple natural family planning system that could be implemented in all countries and cultures across the globe. In addition, the team created CycleBeads to provide a visual, tangible tool to help women follow the method.

To manufacture, sell, and distribute the product, Cycle Technologies licensed the CycleBeads product from IRH and partnered with the organization to bring it to market. Cycle Technologies’ goal for SDM and CycleBeads was to reach users in developing countries where medical and surgical contraception options were limited or unacceptable, as well as those in developed regions where women wanted effective, non-invasive birth control and proactive family planning tools. The first reason for this dual objective was to help establish the credibility of the product. The second reason was that Cycle Technologies hoped to leverage sales in U.S. and other western markets as a mechanism for creating a viable business. This mini-case study describes how Cycle Technologies approached the challenge of establishing a dual market.

[Read Case]

This story is part of the Global Health Innovation Insight Series developed at Stanford University to shed light on the challenges that global health innovators face as they seek to develop and implement new products and services that address needs in resource-constrained settings.  

Acknowledgements: We would like to thank Victoria Jennings of the Institute for Reproductive Health and Leslie Heyer of Cycle Technologies for their participation. This research was supported by the National Institutes of Health grant 1 RC4 TW008781-01.

Photo credit: Courtesy of Cycle Technologies

 

Brilliance II: Achieving Impact Through Licensing

Academic Case Study by:
Stefanos Zenios, Lyn Denend, Julie Manriquez
Published: 2012
[photo - Brilliance]

When team members at D-Rev — a U.S. nonprofit technology company with the mission to improve the health and incomes of people living on less than $4 per day — became interested in the problem of infant jaundice, they initiated a detailed assessment of the phototherapy landscapes in India and Nigeria. Based on insights from that research, the D-Rev team created a prototype for a jaundice treatment product that it called Brilliance. The new phototherapy solution used a high-intensity LED light source that consumed less power than devices with compact fluorescent bulbs (the current standard) and lasted significantly longer. Early test results also revealed that the technology had the potential to perform on par with or better than state-of-the-art phototherapy equipment. 

When D-Rev was ready to start thinking about taking Brilliance to market, the team carefully evaluated its own competencies and concluded that the organization’s strengths were not in product manufacturing or after-sales services. D-Rev did not have the vast expertise and connections needed to establish a sales and distribution network in India, which was its preliminary target market for the device. The team believed it should enter into a licensing agreement to accelerate Brilliance’s market penetration. The challenge was to find the right partner and structure the partnership deal effectively to ensure that D-Rev’s social impact goals would be achieved. This mini-case study explores how D-Rev identified its partner and crafted an agreement to motivate desired behavior.

[Read Case]

This story is part of the Global Health Innovation Insight Series developed at Stanford University to shed light on the challenges that global health innovators face as they seek to develop and implement new products and services that address needs in resource-constrained settings.  

Acknowledgements: We would like to thank Krista Donaldson and Jayanth Chakravarthy of D-Rev for their participation. This research was supported by the National Institutes of Health grant 1 RC4 TW008781-01.

Photo credit: Courtesy of D-Rev

Anacor: Neglected Disease R&D Within a For-Profit Model

Academic Case Study by:
Stefanos Zenios, Lyn Denend, Stacey McCutcheon
Published: 2012
[photo - Anacor]

Anacor Pharmaceuticals, Inc. is a for-profit biotech firm founded in 2002, which focuses on discovering, developing, and commercializing novel small-molecule therapeutics derived from a unique boron chemistry platform. While performing early disease screening, Anacor discovered that this platform showed activity against the causative agents of several neglected bacterial and parasitic diseases. Although CEO David Perry felt a responsibility to apply this technology to the neglected disease space, the company was venture-backed and pre-revenue. As a result, devoting time and money to the pursuit of new therapies for complex, unprofitable global health markets would create a conflict with the objectives of its investors. 

Despite these constraints, Perry was intrigued by the possibility of applying Anacor’s platform to neglected diseases because he, like many others, perceived a need for real innovation in the global health space. This mini-case study describes how Perry and Eric Easom, who became the company’s Program Leader for Neglected Diseases, devised a plan to leverage non-dilutive funding sources to underwrite this important work and the benefits it creates for the company.

[Read Case]

This story is part of the Global Health Innovation Insight Series developed at Stanford University to shed light on the challenges that global health innovators face as they seek to develop and implement new products and services that address needs in resource-constrained settings.  

Acknowledgements: We would like to thank Eric Easom of Anacor for his participation. This research was supported by the National Institutes of Health grant 1 RC4 TW008781-01.

Photo credit: © Juan Carlos Tomasi; reprinted with permission

SafePoint II: Sustaining Adoption

Academic Case Study by:
Stefanos Zenio, Lyn Denend
Published: 2011
[photo - SafePoint]

After reading a newspaper article that predicted the spread of HIV through medical syringes, 

Marc Koska committed himself to addressing the threat of unsafe injections. He spent nearly 10 years in the field, investigating all aspects of the problem: clinical behavior, drug use, patient activity, syringe manufacturing/molding, distribution, disposal, procurement, public health, policy, and funding. The result was the K1 Auto Disable (AD) syringe, which physically prevents reuse by locking the plunger once it has been fully depressed. 

To help raise awareness about the dangers of needle reuse and help stimulate demand for AD syringes, Koska founded a nonprofit called the SafePoint Trust. One of SafePoint’s first activities was to launch an aggressive public awareness campaign in India. As a result of the effort, 26 states in the country switched to using only AD syringes in their public health facilities. 

Unfortunately, this change didn’t stick, with several states reverting to the use of regular syringes over time. This mini-case study describes how Koska modified his approach to driving adoption of AD syringes as SafePoint expanded its program to Tanzania. By devising a more comprehensive adoption strategy, he hoped to create more sustainable results in that country.

[Read Case]

This story is part of the Global Health Innovation Insight Series developed at Stanford University to shed light on the challenges that global health innovators face as they seek to develop and implement new products and services that address needs in resource-constrained settings. 

Acknowledgements: We would like to thank Marc Koska of the SafePoint Trust for his participation. This research was supported by the National Institutes of Health grant 1 RC4 TW008781-01.

Photo credit: © SafePoint

SafePoint I: Stimulating Adoption

Academic Case Study by:
Stefanos Zenios, Lyn Denend
Published: 2011
[photo - SafePoint]

After reading a newspaper article that predicted the spread of HIV through medical syringes, Marc Koska committed himself to addressing the threat of unsafe injections. He spent nearly 10 years in the field, investigating all aspects of the problem: clinical behavior, drug use, patient activity, syringe manufacturing/molding, distribution, disposal, procurement, public health, policy, and funding. The result was the K1 Auto Disable (AD) syringe, which physically prevents reuse by locking the plunger once it has been fully depressed. 

Convinced he had a breakthrough on his hands, Koska shopped the product to the major syringe manufacturers. Unfortunately, these producers understood the need for such a device, but did not believe there was adequate demand to warrant the investment required to produce, sell, and distribute it. Koska gradually convinced organizations such as UNICEF to become customers of the AD syringe, but sales of the device were not growing fast enough to make a real impact. This mini-case study describes why Koska started the nonprofit SafePoint Trust to raise awareness about unsafe injections, as well as the dramatic campaign he launched in India to stimulate the adoption of AD syringes.

[Read Case]

This story is part of the Global Health Innovation Insight Series developed at Stanford University to shed light on the challenges that global health innovators face as they seek to develop and implement new products and services that address needs in resource-constrained settings. 

Acknowledgements: We would like to thank Marc Koska of the SafePoint Trust for his participation. This research was supported by the National Institutes of Health grant 1 RC4 TW008781-01.

Photo credit: © SafePoint

PSI II: Changing Perceptions and Behaviors

Academic Case Study by:
Stefanos Zenios, Lyn Denend, Stacey McCutcheon
Published: 2013
[photo - PSI]

Population Services International (PSI) was founded in 1970 as a nonprofit organization focused on improving reproductive health in developing countries using commercial marketing strategies. Over the years, PSI broadened its mission to address family planning, child and maternal health, and HIV and AIDS prevention, screening, and treatment.

PSI opened an office in Lesotho to launch a condom social marketing program. Shortly thereafter it expanded its scope to include a network of HIV testing and counseling services. In 2010, a donor provided PSI/Lesotho with “a warehouse full” of female condoms (FCs) that the organization could use to help young women in the area protect themselves from HIV/AIDS. The challenge for the team was to figure out how to effectively distribute and promote the FCs since early versions of the female condom were notoriously unpopular. This mini-case study describes the creative approach that PSI devised and implemented to change user perceptions and drive FC adoption, as well as key lessons that it learned through the pilot.

[Read Case]

This story is part of the Global Health Innovation Insight Series developed at Stanford University to shed light on the challenges that global health innovators face as they seek to develop and implement new products and services that address needs in resource-constrained settings. 

Acknowledgements: We would like to thank Brian Pedersen of PSI/Lesotho for his participation. This research was supported by the National Institutes of Health grant 1 RC4 TW008781-01.

Photo credit: Courtesy of PSI/Lesotho

Phoenix II: When Partner Sales Fall Short of Expectations

Academic Case Study by:
Stefanos Zenios, Lyn Denend, Julie Manriquez, Christine Kurihara, Anurag Mairal
Published: 2013
[photo - Phoenix]

Phoenix Medical Systems was founded to manufacture an incubator designed specifically to address the needs of low-resource healthcare providers in India. When leaders from a multinational medical equipment company approached Phoenix about a licensing deal, its founder was enthusiastic about expanding the reach of the organization. Phoenix entered into a two-year contract that allowed the multinational to use its established distribution channels to sell all of the products in the Phoenix portfolio, under the Phoenix brand name, exclusively in the Indian market. Additionally, the multinational would modify several of Phoenix’s products to meet its own international requirements and then manufacture, sell, and distribute them in markets outside India under the multinational’s brand name. 

Although the partnership showed great promise, unfortunately it did not turn out to be as fruitful as initially hoped. This mini-case study describes some of the challenges Phoenix faced with its new partner and how the company responded.

[Read Case]

This story is part of the Global Health Innovation Insight Series developed at Stanford University to shed light on the challenges that global health innovators face as they seek to develop and implement new products and services that address needs in resource-constrained settings. 

Acknowledgements: We would like to thank V. Sashi Kumar of Phoenix Medical Systems for his participation. This research was supported by the National Institutes of Health grant 1 RC4 TW008781-01.

Photo credit: Courtesy of Phoenix Medical Systems

Phoenix I: Generating Preliminary Sales

Academic Case Study by:
Stefanos Zenios, Lyn Denend, Julie Manriquez, Christine Kurihara, Anurag Mairal
Published: 2012
[photo - Phoenix]

Phoenix Medical Systems was founded to manufacture an incubator designed specifically to address the needs of low-resource healthcare providers in India. Initially its founder, who also designed the device, tried selling his incubator through the few medical equipment distributors that existed in India at the time. However, he found this approach to be problematic. Relative to the simple medical products these companies were used to representing, such as syringes and blood pressure cuffs, the incubator was technically complex. The distributors’ sales reps were willing to represent the product, but they didn’t make an effort to understand how it worked so they were unable to position the device effectively and answer the detailed questions that doctors would ask. Phoenix was able to make a small number of sales through this channel, but the product did not gain any significant traction in the market. This mini-case study looks at how Phoenix addressed this obstacle by building its own direct sales force.

[Read Case]

This story is part of the Global Health Innovation Insight Series developed at Stanford University to shed light on the challenges that global health innovators face as they seek to develop and implement new products and services that address needs in resource-constrained settings. 

Acknowledgements: We would like to thank V. Sashi Kumar of Phoenix Medical Systems for his participation. This research was supported by the National Institutes of Health grant 1 RC4 TW008781-01.

Photo credit: Courtesy of Phoenix Medical Systems

PATH II: Demonstrating Products in Rural Areas

Academic Case Study by:
Stefanos Zenios, Lyn Denend
Published: 2012
[photo - PATH]

In late 2006, the PATH Safe Water Project received a $17 million grant from the global development unit of the Bill and Melinda Gates Foundation. Its purpose was to evaluate how market-based approaches could help accelerate the widespread adoption and sustained use of household water treatment and safe storage (HWTS) products among the world’s poor. Traditionally, this sector had been dominated by government and philanthropic solutions. Through a portfolio of field-based pilots, PATH intended to experiment with different commercial models for addressing this dire need.

One of PATH’s pilots tested a direct sales model in Kenya by making a durable safe water product — a ceramic water pot (CWP) — available through a basket of goods approach. The vendors who PATH partnered with were enthusiastic to experiment with offering the CWP. However, they quickly ran into a practical challenge. Consumers, who generally weren’t familiar with CWPs, wanted to see and touch the product, taste the filtered water, and interact with the device before making a purchasing decision. Yet the vendors were unable to carry the bulky, fragile CWPs long distances by foot. This mini-case study explains the creative solution PATH and its partner devised to address this challenge.

[Read Case]

This story is part of the Global Health Innovation Insight Series developed at Stanford University to shed light on the challenges that global health innovators face as they seek to develop and implement new products and services that address needs in resource-constrained settings. 

Acknowledgements: We would like to thank Tim Elliott and the PATH Safe Water Project team for their participation. This research was supported by the National Institutes of Health grant 1 RC4 TW008781-01.

Photo credit: Elizabeth Blanton, courtesy of PATH

Corner